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Can the Brewers’ Mat Gamel Battle Back from His ACL Injury?

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COMMENTARY | A thought along the lines of "this can't possibly be happening to me" was likely crossing the mind of Milwaukee Brewers' first baseman Mat Gamel as he limped back to the away dugout of Petco Park on May 1.

In the very stadium where one-time prized prospect Ryan Braun made his Brewers' debut five years ago against the San Diego Padres, another one-time prized prospect just tore his anterior cruciate ligament. After a painstaking wait to earn a full-time starting position with the club that had drafted him in 2005 -- the same year Milwaukee selected Braun with its first round pick -- Gamel was on the shelf for the rest of the season, and perhaps the remainder of his career with the Brewers.

The future grew dimmer when the Brewers converted right fielder Corey Hart into a first baseman, watching him excel to the point where he was penciled in as the 2013 opening day starter. That is, until Hart suffered some bad news of his own, injuring his right knee and undergoing surgery that will sideline him until May.

All of a sudden, Gamel was back in the exact same scenario as the beginning of last season -- the starting first baseman of the Milwaukee Brewers. Except this time, Gamel had a reconstructed ACL.

Gamel has had his share of bad luck in the past, previously struggling in extended stints at the big league level. He also waited impatiently in the minors for a position on the field to open up with the Brewers, shifting from third base, to the outfield and finally, to first base. Injury should ever be viewed in a positive light, but Gamel received a stroke of good luck with Hart's knee issue, and has a chance to prove himself all over again.

Another bit of good fortune for Gamel was when his injury occurred, only a month into the baseball season. According to assistant general manager Gord Ash, Gamel is "ready to go" after being examined on Jan. 27. Gamel, who was unable to play in the Arizona Fall League, said that he planned on playing in the Dominican Winter League instead, but in the end chose to avoid competition altogether during the offseason.

Although Gamel loses some valuable at-bats in this regard, what's most important is his rehabilitation from ACL surgery and being ready for spring training, which seems to be the case. But when the Brewers say that Gamel is "ready to go," just how ready is he?

There's no question we've seen some significant advancements in ACL surgery in recent years, and because baseball is typically a non-contact sport, tearing the ACL isn't as common of an injury compared to sports like basketball and football. Even so, an ACL injury is often a non-contact injury, which is exactly what happened to Gamel as he chased a popup in foul territory.

Considering how freakish of an injury the ACL tear can be, especially in baseball, the Brewers were dealt some extremely bad luck as starting shortstop Alex Gonzalez tore his ACL just five days after Gamel when sliding into second base. But Milwaukee brought back Gonzalez for the 2013 season to back up Jean Segura, and feels comfortable that he will be ready for spring training and opening day.

Gamel had to delay his surgery for three weeks as he waited for swelling to diminish, but he then immediately got to work in rehabbing his ACL in order to be ready to play in 2013, which is exactly what he accomplished. While he didn't recover as quickly as he had hoped, failing to play in the fall and winter, he didn't suffer any setbacks.

While Gamel paid his dues and then some in the Brewers' farm system, he never encountered any significant injuries, and being just 26 years old at the time of the ACL injury bodes well for Gamel as he is entering the prime of his career.

Rehabilitation and return to normal function after surgical reconstruction of an ACL tear takes 7-9 months, and considering Gamel had his surgery on May 22 of last year, he is right on schedule by being cleared for competition roughly eight months after having surgery.

Gamel has yet to make a name for himself at the Major League level, and as a result, his rehab was not as well documented as one Adrian Peterson, the star running back for the Minnesota Vikings. On Dec. 24, 2011, Peterson suffered a torn ACL of his own when he was clipped by a Washington Redskins' defender.

Just six days later -- in comparison to Gamel's three week wait -- Peterson underwent surgery from the renowned Dr. James Andrews. That's 15 days earlier than Gamel, showing how Peterson was recovering ahead of schedule even before he went under the knife.

Like Gamel, Peterson was 26 years of age at the time of the injury. Of course, Peterson's story has been a truly remarkable one, as he defied all odds and returned for the opening week of the NFL on Sept. 9. That means Peterson took just over eight months to return to play a position that requires cuts, jukes and inducing contact on nearly every play.

Change of direction and helping a person keep their balance happen to be the main functions of the ACL, and while cuts and jukes aren't as prominent in the sport of baseball as they are in football, they are important functions for any athlete that plays a professional sport.

The Brewers' organization and their fans may have been disappointed that Gamel was unable to make up for lost time and catch some playing time during the offseason, but considering the Arizona Fall League and Dominican Winter League came well before the typical recovery window, it shouldn't come as much of a concern.

Meanwhile, Gamel's fellow ACL recovered teammate Alex Gonzalez was healthy enough to play near the end of the Venezuelan Winter League, and because of that, the Brewers are confident he will pass his upcoming physical. If a 35-year-old shortstop was able to return to competitive play faster than a 27-year-old first baseman, what does that say about Gamel?

It's completely understandable that Gamel wasn't physically ready for fall ball, and certainly not out of the question that he simply chose to play it safe with winter ball. After all, Gamel was taking ground balls in early September and didn't suffer any setbacks according to team officials, so for all we know, it was more of Gamel going the "I'd rather be safe than sorry" route.

He was also a sure-fire member of the Brewers roster heading into the 2013 season and didn't want to jeopardize that spot by re-injuring his knee. Meanwhile, Gonzalez was a free agent, trying to show scouts that he was a viable option for their club, so he had more to play for than Gamel.

In regards to past examples of MLB players bouncing back from ACL injuries, Gamel needs to look no further than his current teammate -- starting pitcher Yovani Gallardo.

Gallardo tore his ACL when covering first base during a game against the Chicago Cubs on May 1, 2008, but you wouldn't have known it at the time because the then 22-year-old went on to record five more outs. He would also go on to return that very season to pitch in the postseason exactly five months later.

In 2009, Gallardo went 13-12 with a 3.73 ERA and 204 SOs, and has since gone on to become the team's ace, striking out at least 200 hitters in every full season he's played while never sporting an ERA worse than 3.84. It's safe to say that Gallardo had a Peterson-like recovery, but being a pitcher that doesn't go through the same rigors, his situation must be taken with a grain of salt.

Even so, Gallardo had to rehab to the point where he could push off the surgically rebuilt right knee, run to cover first base and field his position in general. Whether you are a pitcher or a position player in baseball, there aren't many instances that require an immediate change of direction like in other sports, which is likely why Gallardo was able to return that same season.

A notable position player who more recently tore his ACL was Chipper Jones, who suffered the injury on August 10, 2010. Jones, who was 38 at the time, was in the opening day lineup in 2011 and that season managed to hit .275 with 18 HRs and 70 RBIs.

So a player who was 12 years older than Gamel at the time of his ACL injury was able to return to full action in nine months. Medical expert or not, most would agree that bodes well for Gamel, who two months before opening day appears to be full-go.

This might have been a different story before advancements to ACL reconstruction surgery were discovered. In 2011, an anatomic ACL reconstruction method became used by surgeons as a procedure that leads to less post-operative pain, improved range of motion and overall better results down the road.

This technique looks at each patient individually and anchors the ACL to its original bodily position, keeping the natural structure of the knee. By doing this, the patient is less likely to suffer a repeat tear and is able to return to activities in less time.

This development likely benefited athletes like Peterson and Gamel, and the improvements in the surgery go back even further. In 2009, the "anatomic footprint" technique began picking up steam, as it "provides patients anterior/posterior as well as rotational stability of the knee and durable long-term function in high demand activity." Using a hamstring tendon as an ACL graft -- which must be worked into place during rehab -- has also become common practice.

But enough with the medical speak -- in layman's terms, ACL surgeries are way better than they were 10 years ago, and athletes can now recover faster as a result, bringing that 7-9 month recovery period down closer to seven. Assuming Gamel benefited from these advancements during his rehab, there's no reason he shouldn't be 100 percent heading into spring training.

Becoming re-acclimated to game speed and realizing his potential is in Gamel's hands, but nobody has played a Major League Baseball game since October, so in that regard, Gamel levels the playing field.

Being 27-years-old with the ability to steal bases, Gamel has the athleticism. And a career .304 AVG with over 100 HRs in his minor league career proves he has the pedigree. In other words, it's not the ACL injury we should be concerned about at this point.

With his knee conceivably fixed, there's just one question we need answered from Gamel - can he fix his game?

Dave Radcliffe lives in a little known Milwaukee suburb and is a self-proclaimed Wisconsin sports expert who has contributed to JSOnline and as a featured columnist among other sites and publications.

You can follow Dave on Twitter @DaveRadcliffe_.

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